Evaluation of breast cancer mammography screening policies considering adherence behavior.
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| Title: | Evaluation of breast cancer mammography screening policies considering adherence behavior. |
|---|---|
| Authors: | Madadi, Mahboubeh1 mmadadi@uark.edu, Zhang, Shengfan1 shengfan@uark.edu, Henderson, Louise M.2 louise_henderson@med.unc.edu |
| Source: | European Journal of Operational Research. Dec2015, Vol. 247 Issue 2, p630-640. 11p. |
| Subjects: | Breast cancer diagnosis, Mammograms, Longitudinal method, Discrete-time systems, American Cancer Society Inc. |
| Abstract: | Mammography is known to be the most effective way of breast cancer detection. The efficacy of mammography screening guidelines is highly associated with women's compliance with these recommendations. Currently, none of the existing policies takes women's behavior into consideration; instead, perfect adherence is assumed. However, an earlier longitudinal data analysis has revealed that women's compliance with mammography guidelines remained low in recent years. In this study, we develop a randomized discrete-time finite-horizon partially observable Markov chain model to evaluate a wide range of screening mammography policies, incorporating heterogeneity in women's adherence behaviors. Considering potential harms of mammography tests (e.g., risk of developing radiation-induced breast cancer, false negatives, false positives, etc.), policies with varying starting age, ending age and frequency of screening mammograms at different ages are compared in terms of total quality adjusted life years (QALYs) and lifetime breast cancer mortality risk. Our results show that women with perfect adherence do not always experience higher QALYs. In fact, for some policies, including the American Cancer Society (ACS) policy, the general population with various adherence levels has higher QALYs than women with perfect adherence. However, in terms of lifetime breast cancer mortality risk, higher/perfect adherence always results in lower risk of dying from breast cancer. This implies that the benefits of mammography in decreasing death from breast cancer outweigh the increased risk of developing radiation-induced breast cancer from mammographic screening. This study can facilitate healthcare providers to tailor screening mammography recommendations based on their patients' estimated adherence levels. [ABSTRACT FROM AUTHOR] |
| Copyright of European Journal of Operational Research is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Engineering Source |
| FullText | Text: Availability: 0 |
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| Header | DbId: egs DbLabel: Engineering Source An: 108724451 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Evaluation of breast cancer mammography screening policies considering adherence behavior. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Madadi%2C+Mahboubeh%22">Madadi, Mahboubeh</searchLink><relatesTo>1</relatesTo><i> mmadadi@uark.edu</i><br /><searchLink fieldCode="AR" term="%22Zhang%2C+Shengfan%22">Zhang, Shengfan</searchLink><relatesTo>1</relatesTo><i> shengfan@uark.edu</i><br /><searchLink fieldCode="AR" term="%22Henderson%2C+Louise+M%2E%22">Henderson, Louise M.</searchLink><relatesTo>2</relatesTo><i> louise_henderson@med.unc.edu</i> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Operational+Research%22">European Journal of Operational Research</searchLink>. Dec2015, Vol. 247 Issue 2, p630-640. 11p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Breast+cancer+diagnosis%22">Breast cancer diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Mammograms%22">Mammograms</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Discrete-time+systems%22">Discrete-time systems</searchLink><br /><searchLink fieldCode="DE" term="%22American+Cancer+Society+Inc%2E%22">American Cancer Society Inc.</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Mammography is known to be the most effective way of breast cancer detection. The efficacy of mammography screening guidelines is highly associated with women's compliance with these recommendations. Currently, none of the existing policies takes women's behavior into consideration; instead, perfect adherence is assumed. However, an earlier longitudinal data analysis has revealed that women's compliance with mammography guidelines remained low in recent years. In this study, we develop a randomized discrete-time finite-horizon partially observable Markov chain model to evaluate a wide range of screening mammography policies, incorporating heterogeneity in women's adherence behaviors. Considering potential harms of mammography tests (e.g., risk of developing radiation-induced breast cancer, false negatives, false positives, etc.), policies with varying starting age, ending age and frequency of screening mammograms at different ages are compared in terms of total quality adjusted life years (QALYs) and lifetime breast cancer mortality risk. Our results show that women with perfect adherence do not always experience higher QALYs. In fact, for some policies, including the American Cancer Society (ACS) policy, the general population with various adherence levels has higher QALYs than women with perfect adherence. However, in terms of lifetime breast cancer mortality risk, higher/perfect adherence always results in lower risk of dying from breast cancer. This implies that the benefits of mammography in decreasing death from breast cancer outweigh the increased risk of developing radiation-induced breast cancer from mammographic screening. This study can facilitate healthcare providers to tailor screening mammography recommendations based on their patients' estimated adherence levels. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Journal of Operational Research is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1016/j.ejor.2015.05.068 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 11 StartPage: 630 Subjects: – SubjectFull: Breast cancer diagnosis Type: general – SubjectFull: Mammograms Type: general – SubjectFull: Longitudinal method Type: general – SubjectFull: Discrete-time systems Type: general – SubjectFull: American Cancer Society Inc. Type: general Titles: – TitleFull: Evaluation of breast cancer mammography screening policies considering adherence behavior. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Madadi, Mahboubeh – PersonEntity: Name: NameFull: Zhang, Shengfan – PersonEntity: Name: NameFull: Henderson, Louise M. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 12 Text: Dec2015 Type: published Y: 2015 Identifiers: – Type: issn-print Value: 03772217 Numbering: – Type: volume Value: 247 – Type: issue Value: 2 Titles: – TitleFull: European Journal of Operational Research Type: main |
| ResultId | 1 |
